Epidemic Leadership. Larry McEvoy

Epidemic Leadership - Larry McEvoy


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to understand how to move entire systems so they could respond without relying on running people ragged as a workaround. I saw eyes widen—just barely, but I saw it—and then heard a hastily formed reply uttered in a soothing voice: “We start with ourselves, the only thing we really can control, and you can only do what you can do.” Perfectly sensible.

      After the conversation with the nurses, patients began to trickle in as morning arrived. I finished the shift and drove home to where I lived west of town. I opened the ranch gate to our place and paused to take in the land where I lived. It was a quiet ritual of mine that created space between the sights and sounds of my job and the world of my family. Depending on which shift I had just worked, I took a few minutes under the stars or the bright sun to let the insights of the work settle in and to let the sometimes assaulting nature of it wash out onto the ground.

      The bright morning air, still cool, held the hint of another hot day, and the slanting sun cast dark shadows on the sun-washed ponderosa coulees and grassy ridges. There is nothing better to wash the olfactory memory of alcohol, blood, urine, and pus from one's brain than the morning smell of sage and Ponderosa pine, nothing better to replace the beeping of monitors and moans of the sick than the breeze wandering in the grassy air. Surrounded by healthier sounds and sights in my sleep-deprived, almost-to-sleep ease, it struck me that the epidemics that cause such ill consequence among us—obesity, cardiovascular disease, HIV, gun violence—were playing by a different set of rules than the ones underlying how I had been taught to respond to them.

      I had grown up here in this place of big land and teeming life, raised and surrounded by people who had me in it early and often. I had long wondered how the elegance of biology, so essential to the enduring vitality of every person and every living thing on this planet, did not seem to translate to how we designed organizations, leadership approaches, team dynamics, or even our internal mindsets. The exponential trends that bedeviled me as a doctor and inspired me as a landowner were playing by biological rules; our responses seemed to be so much more mechanical and rigid. And slower. And ineffective. And falling behind.

      I wasn't thinking of epidemics as leadership that morning. I only knew at that time that I was on the right side of wanting to be helpful and the wrong side of the way things launched, grew, spread, and moved. From the patients I attended to the land I lived on, I understood biology held vitalizing, relentless capacity. Beyond that, I was out of ideas, and I was too long without sleep.

      I went down into the darkest room in my house and fell into the motionless, dreamless sleep of the night worker.

      1 1 Tait D. Shanafelt, MD, et al., “Changes in Burnout and Satisfaction with Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014,” Mayo Clinic Proceedings 90, no. 12 (December 1, 2015): 1600–1613, https://doi.org/10.1016/j.mayocp.2015.08.023.

      2 2 Maria Panagioti et al., “Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction: A Systematic Review and Meta-analysis,” JAMA Internal Medicine 178, no. 10 (October 1, 2018): 1317–1331, https://doi.org/10.1001/jamainternmed.2018.3713.

      3 3 “The Impact of Burnout on Healthcare Executives: A WittKieffer Study,” WittKieffer.com, online survey conducted summer 2018, https://www.wittkieffer.com/thought-leadership/impact-of-burnout-on-healthcare-executives-witt-kieffer-study/.

      4 4 Ben Wigert and Sangeeta Agrawal, “Employee Burnout, Part 1: The 5 Main Causes,” Gallup Workplace, July 12, 2018, https://www.gallup.com/workplace/237059/employee-burnout-part-main-causes.aspx.

      Nature does not hurry, yet everything is accomplished.

       —Lao Tzu

      In 2008, several years removed from my discouraging night in the ER, I took a role as the CEO of what was then Colorado's


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